migraine equivalent headaches

[Tim__0]

    
      Re: Re: migraine equivalent headaches
    


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Posted by CCF Neuro MD on August 14, 1997 at 11:13:35:

In Reply to: Re: migraine equivalent headaches posted by Andrew on August 04, 1997 at 15:11:34:

: : I have been experiencing ocaasional numbness/tingling on the left side of my face for approx
  : six months.  Usually this has been accompanied by mild headaches and nausea.  Initially my  doctor
  : ordered a medrol pack to prevent a Bell's Palsy onset.  This provided no relief.  He then orfered
  : an MRI/MRA which was normal.  He now believs these episodes may be migraine equivalents.  Can you provide
  : any information or insigth into this?
  : Thank you.
  It might be worth getting tested for Lyme Disease, as I was told that I was suffering from "migraine equivalency" by a neurologist after having suffered strange cranial neuropathies such as you describe. I am currently beginning treatment for late stage lyme disease. It may be necessary to be tested by more than one means also, as it is not unusual to appear seronegative in late stages, which was the case for me, and made diagnosis more elusive.
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Dear Tim:
A minority of patients with migraine (which is the very common episodic throbbing headache disorder seen in the general population) develop transient neurological symptoms or signs (called the aura) prior to or at the time of onset of a bout of headache. Commonly, this symptom is visual, consisting of wavy lines or flashes of light spreading through the visual field lasting for several minutes and subsiding as the headache intensifies. Less commonly, there can be transient numbness of the face or hand, weakness, speech difficulty, confusion, vertigo, or impairment of conscious. These alarming signs are recognised as being relatively benign by the patient and by the neurologist by their regular association with a habitual migraine spell.
Migraines run in families; individuals with a tendency to develop migraine headaches may not develop typical headache spells, or may outgrow these. Some of these individuals, specially in their later years, begin developing spells which are essentially isolated auras (flashes of light/numbness/weakness) without associated headaches. Such auras are termed “migraine equivalents”. These spells can be specially alarming at this age because, more ominous cerebrovascular disease is also very prevalent. The diagnosis of migraine equivalents remains clinical, after the exclusion of major underlying disease.
A good neurologist should not confuse cranial neuropathy due to Lyme disease with migraine equivalents.
If you are sufficiently concerned, there is no harm in seeking a second opinion from a neurologist. If you live in the Cleveland area, I suggest that you see any of the headache specialists at the Cleveland Clinic. Drs. Gretter, Kunkel, Skobieranda, and Solomon are nationally renowned.
An appointment can be made at the Cleveland Clinic by calling up (216)44-5665, or [phone] toll free.
I wish you the best of luck.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.